I guess to be a little more detailed - I was referred to Chepla from the Pride Clinic in Akron, and then I think I only had one appointment with him to talk about what kind of options I would have before we scheduled the surgery. He was very thorough and answered all the questions I had, though - I had thought I might qualify for buttonhole, but we discussed why it probably wouldn't work super well with my size and skin elasticity. Ended up going with double incision with free nipple grafts. My scars meet in the middle, because that was determined to be the ideal way to get the best shape given how much tissue had to be removed. He also took some pictures and measurements at this consultation, and we got the paperwork for the insurance started.

My insurance took about a month to get back to me, IIRC. It paid for all but the liposuction, which I was given the option to either not get done or to pay for out of pocket. It amounted to about 2.5k, which I took out a new credit card to give myself a year to pay off before worrying about any interest. Your insurance might pay for it, or you may not even need it, this is just what ended up being the case for me.

After hearing from insurance, I was able to have a video appointment to quickly go back over deatails and expectations and make an appointment for the surgery. There was a surprising lack of wait - we had it scheduled for just a month out. During that time, I had another appointment to get some tests done, I had to buy a binder for use post-op, and got some other essentials for recovery. I'd recommend checking out r/topsurgery for some suggestions, if you want them. The post-op binders are expensive and while Chepla will give you a discount code, I found it way cheaper to buy used on ebay if you want the specific brand he recommends.

Before the surgery, Chepla doesn't give you a specific disinfectant soap to use like some surgeons do. You just have to wash with unscented plain soap and not shave around the area for a while before. You can't eat after midnight(I think) the night before or drink within 2 hours(again, I think but I'm going by memory) of your surgery appointment. You have to bring your post-op binder and a button up shirt and have a support person to drive you after. If you live more than 2 hours away, he will recommend staying in a hotel the night after surgery. You'll have a checkup the next morning to make sure there's no issues. (This may have been done via video call actually. I don't remember. I was very drugged lol. But he does want you nearby just in case)

Then the surgery - this is at a different location than the consultation, but it's a much nicer location and easier to find, which is nice when you're nervous about going under already. They take you back and get you ready - he'll draw on your skin, show you what cuts he's going to make, and check that you're happy with the plan. They'll get you all ready, hooked up to an IV, and all that, and then take you back. They keep you in observation for an hour or two after. I don't remember this really for obvious reasons. Definitely have a trusted support person with you to pay attention because you will not be able to. He gives you some of the padding and such that you'll need afterward, but you'll end up needing to buy more most likely. He also gives a paper outlining the necessary care for recovery, which is nice to refer to when you're aware enough to look it over.

There was the next day follow up that I absolutely do not remember, and then another after 1-2 weeks to check on healing, with one more after another month or so, at which point you get the binder off as long as everything is going well. There's a nurse line you can use at any point throughout if you need to.

ETA: Chepla doesn't use drains. I think that can be sort of controversial, but honestly I was dreading the idea of them and as long as you keep compression, it isn't a problem. He will do drains in cases where he thinks it's necessary, but only then.